Policy Review of Health Services for Abandoned Children Without National Identification Number (NIK) Under BPJS Health System
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Abstract:
Background of study: This study examines the legal and administrative challenges faced by hospitals in providing BPJS Health services to abandoned children without a National Identification Number (NIK) in Indonesia. Despite constitutional guarantees of healthcare for all citizens, the absence of explicit regulatory mechanisms for patients without formal identification creates significant financial and operational risks for healthcare providers.
Aims and scope of paper: The research aims to analyze the policy gaps in the BPJS Health system regarding coverage for abandoned children without NIK and to assess the resulting implications for hospital operations and health equity. It focuses on evaluating existing regulations and their implementation through a health policy framework.
Methods: A qualitative policy analysis was conducted using Walt & Gilson's Policy Triangle framework (context, process, actors, content) and the concept of health equity. Data were collected through a comprehensive review of legal documents, government regulations, academic literature, and reports on BPJS claim processes
Result: The analysis reveals significant regulatory gaps, as current policies do not explicitly include abandoned children without NIK as eligible beneficiaries. Hospitals face substantial administrative barriers, with 61.39% of claim delays attributed to incomplete documentation. Services for these children are often categorized as unfunded emergency or social care, creating financial strain on healthcare facilities and inconsistent access for vulnerable populations.
Conclusion: The study concludes that clear legal instruments and standardized operational procedures are urgently needed to protect hospitals, ensure transparent claim mechanisms, and guarantee equitable healthcare access for abandoned children without NIK. Policy reforms should address both administrative requirements and systemic coordination among stakeholders to achieve true universal health coverage.
Keywords: BPJS Health, abandoned children, legal certainty, hospital claims, NIK
Copyright (c) 2026 Irma Yudith Ayu Puspita, Susi Mulyati, Dian Mahanani
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Achadi, E. L., Taher, A., Wirawan, F., Sungkar, S., Sudarmono, P., Shankar, A. H., Thabrany, H., & Soewondo, P. (2019). Universal health coverage in Indonesia: concept, progress, and challenges. The Lancet, 393(10166), 75–102. https://doi.org/10.1016/S0140-6736(18)31647-7
Clifford, N., Blanco, N., Bang, S. H., Heitkemper, E., & Garcia, A. A. (2023). Barriers and facilitators to healthcare for people without documentation status: A systematic integrative literature review. Journal of advanced nursing, 79(11), 4164–4195. https://doi.org/10.1111/jan.15845
Hacker, K., Anies, M., Folb, B. L., & Zallman, L. (2015). Barriers to health care for undocumented immigrants: a literature review. Risk management and healthcare policy, 8, 175–183. https://doi.org/10.2147/RMHP.S70173
Haris, A., & Saleh, I. (2021). Muhammadiyah and the empowerment of street children in Indonesia. International Journal of Social Science and Human Research, 4(10), 2752–2762. https://doi.org/10.47191/ijsshr/v4i10-16
Indonesia. (1945). *Undang-Undang Dasar Negara Republik Indonesia Tahun 1945* [The 1945 Constitution of the Republic of Indonesia].
Indonesia. (2011). *Undang-Undang Republik Indonesia Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial* [Law No. 24 of 2011 on Social Security Administering Bodies].
Indonesia. (2018). Peraturan Presiden Republik Indonesia Nomor 82 Tahun 2018 tentang Jaminan Kesehatan [Presidential Regulation No. 82 of 2018 on Health Insurance].
Indonesia. (2023). *Undang-Undang Republik Indonesia Nomor 17 Tahun 2023 tentang Kesehatan* [Law No. 17 of 2023 on Health].
Indonesia. (2024). Peraturan Pemerintah Republik Indonesia Nomor 28 Tahun 2024 tentang Penyelenggaraan Bidang Kesehatan [Government Regulation No. 28 of 2024 on the Implementation of the Health Sector].
Pisani, E., Olivier Kok, M., & Nugroho, K. (2017). Indonesia's road to universal health coverage: a political journey. Health Policy and Planning, 32(2), 267–276. https://doi.org/10.1093/heapol/czw120
Prasetyo, G. (2015). Perlindungan hukum terhadap anak terlantar dalam memperoleh jaminan kesehatan oleh badan penyelenggara jaminan sosial kesehatan [Legal protection for abandoned children in obtaining health insurance through social security administering bodies]. Jurnal Hukum, 2(4), 134–144.
Ramadhani, A. N., Aspan, Z., & Hasrul, M. (2021). Legal protection for unregistered citizen at healthcare and social security agency (BPJS). Jurnal Hukum Volkgeist, 6(1), 1–10. https://doi.org/10.35326/volkgeist.v6i1.1537
Asya, J., Suryono, A., Makbul, A., Tinggi, S., Militer, H., Jakarta, D. K. I., & E-mail, I. (2024). Jurnal HUKUM dan KENOTARIATAN The Consistency of National Health Implementation in Achieving Health Equity. 8(3), 144–166. https://doi.org/10.33474/hukeno.v8i3.22572
Azizatunnisa, L., Kuper, H., Probandari, A., & Morgon, L. (2026). SSM - Health Systems and facilitators of people with disabilities in Indonesia in accessing and using Jaminan Kesehatan Nasional ( National Health Insurance ). SSM - Health Systems, 6(July 2025), 100171. https://doi.org/10.1016/j.ssmhs.2026.100171
Cheng, Q., Fattah, R. A., Susilo, D., Satrya, A., Haemmerli, M., Kosen, S., Novitasari, D., Puteri, G. C., Adawiyah, E., Hayen, A., Mills, A., Tangcharoensathien, V., Jan, S., Thabrany, H., & Asante, A. (2025). Determinants of healthcare utilization under the Indonesian national health insurance system – a cross ‑ sectional study. BMC Health Services Research. https://doi.org/10.1186/s12913-024-11951-8
Listyaningrum, N. (2025). Legal Perspectives on Healthcare Inequality in Indonesia. 33(1), 272–296. https://doi.org/10.19105/karsa.v33i1.20302
Puspitaningrum, R. A., Probandari, A., Pamungkasari, E. P., Ardyanto, T. D., & Fitriana, E. N. (2019). Achievement of universal health coverage in Surakarta city: policy analysis. 149–161. https://doi.org/10.20885/JKKI.Vol10.Iss2.art7
Ramadani, M. F., Arimbi, D., & Dwiprigitaningtias, I. (2023). Legal Protection For National Health Insurance Patients Regarding The Right To Service Facilities Based On Law Perlindungan Hukum Pasien Jaminan Kesehatan Nasional Atas Hak Pelayanan Fasilitas Berdasarkan Undang – Undang. https://doi.org/10.36859/rechtswetenschap.v2i2.4154
Ramadani, N. A., Simanjuntak, G. Y., & Putri, D. N. (2025). Policy Implementation in Resource-Scarce Political Environments : Applying Peter S . Cleaves ’ Framework to Indonesia ’ s National Health Insurance ( JKN ). 66–78.
Rodney, A. M., & Hill, P. S. (2014). Achieving equity within universal health coverage : a narrative review of progress and resources for measuring success. 1–8. https://doi.org/10.1186/s12939-014-0072-8
Samart, & Rinehart. (2024). MOVER: Medical Informatics Operating Room Vitals and Events Repositor. https://doi.org/10.1101/2023.03.03.23286777
Sartono, RRahmat, S. M., Arfiyah, G., & Prayut, Yu. (2025). Hak Atas Kesehatan Dan Tanggung Jawab Negara: Konstruksi Hukum Dalam Perlindungan Pasien Bpjs. 2337, 832–850. https://doi.org/10.36987/jiad.v13i3.7489
Sulistiyono, F. O., Efendi, A., & Al-Khanif. (2025). Tanggung Jawab Negara Memelihara Anak Terlantar Perspektif Pendahuluan Keselamatan dan kesejahteraan anak merupakan hak-hak anak yang harus. Constitution Journal, 4(1), 61–78. https://doi.org/10.35719/cinstitution.v4i1.133
Tehupeiory, A. (2021). Bahan ajar metode penelitian hukum [Teaching materials for legal research methods]. UKI Press.
Zahidie, A., Asif, S., & Iqbal, M. (2023). Building on the health policy analysis triangle: Elucidation of the elements. Pakistan Journal of Medical Sciences, 39(6), 1865–1868. https://doi.org/10.12669/pjms.39.6.7056
